Supraventricular arrhythmia following lung resection for non-small cell lung cancer and its treatment with amiodarone✩
Open Access
- 1 July 2000
- journal article
- Published by Oxford University Press (OUP) in European Journal of Cardio-Thoracic Surgery
- Vol. 18 (1), 12-16
- https://doi.org/10.1016/s1010-7940(00)00428-0
Abstract
Objective: From January 1998 to February 1999, 160 patients undergoing lung resection for non-small cell lung cancer were studied to define factors that increase the risk of postoperative supraventricular arrhythmia (SA) and to assess the effectiveness of amiodarone as an antiarrhythmic drug. Methods: All patients were monitored intraoperatively and postoperatively up to day 3. Onset of SA was documented with ECG. Amiodarone was administered to those who developed SA with a loading dose of 5 mg/kg in 30 min and a maintenance dose of 15 mg/kg in 24 h. Results: Mean age was 64 years (range 27–83 years). There were nine wedge resections, six segmentectomies, 127 lobectomies and 18 pneumonectomies. Twenty-two patients (13%) had SA, all of which were atrial fibrillations. The incidence of supraventricular arrhythmia with pneumonectomy and lobectomy was 33 and 12%, respectively (P=0.02). None of the patients who had a minor resection developed SA. The peak incidence of onset of SA occurred on postoperative day 2 and lasted from 1 to 12 days (average 3.4 days). Sinus rhythm was achieved with amiodarone in 20 patients (90.9%) with no side effects. Two patients received electrical cardioversion because hemodynamically unstable. Mean preoperative pO2 and pCO2 were lower in patients with SA: pO2 80.8 vs. 85 mmHg (P=0.04); pCO2 35.5 vs. 38 mmHg (P=0.01). Patients with concomitant cardiopulmonary diseases presented an odds ratio for postoperative arrhythmia of 12.4 (confidence interval 4.5–34.1) (P≪0.0001). Conclusion: Concomitant cardiopulmonary diseases, lower pO2, pCO2 and extent of surgery increase the risk of postoperative SA after lung resection for non-small cell lung cancer. Cardiac monitoring in patients at risk is recommended. Amiodarone was both safe and effective in establishing and maintaining sinus rhythm.Keywords
This publication has 16 references indexed in Scilit:
- Incidence and predictors of supraventricular dysrhythmias after pulmonary resectionThe Annals of Thoracic Surgery, 1998
- Effects of diltiazem versus digoxin on dysrhythmias and cardiac function after pneumonectomyThe Annals of Thoracic Surgery, 1997
- Prevention of Atrial Tachyarrhythmias After Non-Cardiac Thoracic Surgery by Infusion of Magnesium SulfateThe Thoracic and Cardiovascular Surgeon, 1996
- Verapamil as prophylactic treatment for atrial fibrillation after lung operationsThe Annals of Thoracic Surgery, 1996
- Prospective analysis of pneumonectomy: Risk factors for major morbidity and cardiac dysrhythmiasThe Annals of Thoracic Surgery, 1996
- Amiodarone and the Development of ARDS After Lung SurgerySocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 1994
- What are the risk factors for arrhythmias after thoracic operations?The Journal of Thoracic and Cardiovascular Surgery, 1993
- Cardiac arrhythmias and myocardial ischemia after thoracotomy for lung cancerThe Annals of Thoracic Surgery, 1992
- Prophylactic digitalization for thoracotomy: A reassessmentThe Annals of Thoracic Surgery, 1990
- Cardiac Dysrhythmia following PneumonectomySocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 1987